Healthcare Provider Details

I. General information

NPI: 1922888932
Provider Name (Legal Business Name): MT. CARMEL ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20292 HWY 90 FRONTAGE RD
JEANERETTE LA
70544-8560
US

IV. Provider business mailing address

20292 HWY 90 FRONTAGE RD
JEANERETTE LA
70544-8560
US

V. Phone/Fax

Practice location:
  • Phone: 337-254-4535
  • Fax:
Mailing address:
  • Phone: 337-254-4535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLES MATTHEWS
Title or Position: CEO
Credential:
Phone: 337-254-4535